PBIS Maryland:Current Interagency

ApproachSusan Barrett

Sheppard Pratt Health System

Milt McKennaMaryland State Department of Education (MSDE)

Oct. 11, 2006Rosemont, IL

Pennsylvania

Delaw

are

D.C.

Virginia

West Virginia

Maryland Organizational Model

School Level 467 PBIS Teams (one per school)

- Team leaders (one per school)

- Behavior Support Coaches (250+)

District Level (24) Regional Coordinators

State Level State Leadership Team

- Maryland State Department of Education (MSDE)- Sheppard Pratt Health System- Johns Hopkins Center for Prevention of Youth Violence- 24 Local school districts- Department of Juvenile Services, Mental Health Administration

Management Team Advisory Group

National Level National PBIS Technical Assistance Center

- University of Oregon & University of Connecticut

State

District

School

Classroom

Student

Cumulative Number of PBIS School Teams and Behavior Support Coaches by

Year Trained

050

100150200250300350400450500

1999 2000 2001 2002 2003 2004 2005 2006Year

Schools Trained

Coaches

# T

rain

ed

364434

504574

644714

0

100

200

300

400

500

600

700

800

FY 05 FY 06 FY 07 FY 08 FY 09 FY 10

Anticipated Growth at 5% Linear (Anticipated Growth at 5%)

Anticipated GrowthCurrently 34% of MD schools trained

& 50% will be trained by 2010

Annual Training and Support Events

• Spring Forum (March) ~ 400• Summer Training Institute (June)

• New Teams ~ 830: Central• Returning Teams ~ 1600: 3 regional events

• Coaches Meetings (3 per year) ~ 120• 5 Regional / District Meetings (2 per year)

• Special Schools (2 per year)

• High Schools (2 per year)

PBIS Maryland: Political Support and

VisibilityAndrea Alexander

Maryland State Department of Education (MSDE)

Michelle ZabelUniversity of Maryland

Oct. 11, 2006Rosemont, IL

Current Energy and Efforts

• Institutionalize funding level and commitment at MSDE- Divisions of Student Services and Special Education

• Pursue other funding opportunities• Expand and sustain green zone with high fidelity• Increase marketing and visibility• Implement yellow zone in districts that have solid

green zone and have infrastructure to expand• Continue linkage with school mental health,

Systems of Care, and wraparound efforts

Annotated Code of Maryland State Board of

Education

• Subtitle 08 STUDENTS • Chapter 06: • Positive Behavioral Interventions and

Support Program Authority: 13A.08.06.00 • Title 13A Education Article, §2-205 and 7-

304.1

A. Upon receipt of notification from the Department that an elementary school's suspension rate exceeds 18 percent, the local school superintendent or the superintendent's designee shall direct the principal of the school to implement: (1) PBIS; or (2) An alternative behavioral modification program developed in collaboration

with the Department. B. The school principal or the principal's designee and appropriate staff members

shall develop a plan for implementing a program as set forth in §A of this regulation.

C. The following apply to an elementary school that has at least one grade beyond grade 5: (1) The 18 percent suspension rate in §A of this regulation shall apply to students in pre-kindergarten through grade 5; and (2) PBIS or the alternative behavioral modification program shall focus on students in pre-kindergarten through grade 5.

D. Nothing in this regulation precludes a school system from implementing PBIS or an alternative behavioral modification program either in specific schools or system-wide.

Legislation Requiring PBIS Implementation

Related State-Level Child Mental Health Programs: Agreed Underlying Values and Intended Outcomes

HB 1386:• Improving access to services for children with

intensive needs• Developing community based resources for

children with intensive needs and children at risk of residential placement

• Reducing the number of children in placements outside of their home communities

Maryland’s Approach to Children's Mental Health

• Systems of Care• Local Access Mechanisms

• Navigation functions• Single point of access/no wrong door

• Wraparound – practice model

Identified How Services & Supports Will Be Organized

Governor’s Office for Children Local Management Boards

Children’s Cabinet

State Agencies(DHMH, DHR, DJS, MSDE)

Local Agency Partners(CSA, DSS, DJS, LSS)

Children, Families and CommunitiesDHMH = Department of Health & Mental Hygiene CSA = Core Service Agency (local mental health)DHR = Department of Human Resources (Child Welfare) DSS = Department of Social ServicesDJS = Department of Juvenile Services DJS = Local/Regional OfficeMSDE = Maryland Department of Education LSS = Local School System

Wraparound Implementation

Wraparound Funding-develop case rate or alternate funding

mechanism for each enrolled child

Local Management Board (LMB)

Care Management Entity/Unit(could be LMB)

-organize and manage provider network-staff and mange referral and billing process

-responsible for quality assurance and outcome mgmt. and monitoring

Care Coordinator (could be part of Care Management Entity/Unit)-creates child and family team and individualized treatment plan

ProviderProviderProvider

The Commitment:

Governor Robert L. Ehrlich Jr.’s Executive OrderJanuary, 2003 - Custody Relinquishment and Access to Services for Children

House Bill 13862002 Session – Children with Intensive Needs

Mental Health Transformation State Incentive Grant 2005 SAMHSA grant award

PBIS Maryland: Evaluation &

Demonstrations Jerry Bloom

Sheppard Pratt Health System

Catherine Bradshaw & Phil LeafJohns Hopkins Bloomberg School of Public Health

Susan BarrettSheppard Pratt Health System

Nancy LeverUniversity of Maryland

Oct. 11, 2006Rosemont, IL

Evaluation Questions• What schools have been trained and are active?• How well are schools implementing PBIS?• What impact does PBIS have on behavior & achievement?Evaluation Tools• Team Implementation Checklist• SWIS• SET• Coaches Checklist• Staff Survey• Satisfaction Surveys• Implementation Phases Inventory (IPI)

Evaluation CapacityEstablishing Measurable Outcomes

Evaluation Tools• Maryland website www.pbismaryland.org• Various Levels:

• Any user• Team/coach• District Point of Contact• State Team

• Maryland Forms Matrix• Access Database

• Data Entry and Storage• Report Generation

• SWIS • PBS surveys (www.pbssurveys.org)

Randomized Trial of PBIS: Project Target

Funding• Phil Leaf, PI• Centers for Disease Control &

Prevention (CDC)• National Institute of Mental Health

(NIMH)Goal: Determine Impact of PBIS

on• Student Behavior

- Discipline referrals - Disruptive behavior- Academic achievement

• School Environment- School climate- Organizational health

Sample• 37 Elementary Schools

- 5 Counties • 3,454 Staff• 26,143 Students

Design• Randomly Assigned

- 21 PBIS- 16 Focus

• Baseline + 4 years

Preliminary Findings from Project Target

• PBIS schools have high program fidelity• PBIS increased organizational health • Some positive effects on student outcomes

• Reduced office discipline referrals• Reduced suspensions

Project Target

Related InitiativesBullying Prevention

• Using Internet to facilitate data-based decision making• Provides school teams with local data to inform school improvement plans

PBIS + FBA• Grant under review to test combination of SW-PBIS and FBA (P. Leaf, PI)• In collaboration with Terry Scott• On-site technical assistance in simplified FBA

Center for the Prevention of Youth Violence• Funded by CDC (Phil Leaf, PI)• Focused on Baltimore City

Center for Prevention and Early Intervention • Funded by NIMH & NIDA (Nick Ialongo, PI)• Focused on Baltimore City• Piloting evidence-based mental health programs

Yellow Zone Program: Behavior Education Program (BEP)

Target• Districts with solid green zone and infrastructure to support

yellow zone expansion

Training Materials• Responding to Problem Behavior in Schools: The Behavior

Education Program (Crone, Horner, & Hawken)• Locally developed CD

Training Format• Regional training of school teams• On-site technical assistance & support

Evaluation & Expansion• Preliminary findings positive

Expanded School Mental Health (ESMH)

• Full continuum of mental health services for children and adolescents in both regular and special education.

• Evaluation• Treatment• Case Management• Mental Health Promotion• Prevention• Crisis Management• Consultation

• ESMH augments services offered by school hired staff and is designed to fill in gaps in care

Maryland’s School Mental Health Integration Grant

(USDOE)

Aim 1: To further build a systematic state initiative for school mental health (SMH)

Aim 2: To improve outcomes related to red and yellow zone youth in PBIS schools through:

1. Helping school staff to better identify and refer students who could benefit from mental health services

2. Enhancing mechanisms for effective communication between schools and the mental health system to help better integrate quality mental health care for students

3. Developing training and resources to assist school staff with creating environments that support academic, social, and emotional learning for children with more intensive mental health needs

OUTCOMESINPUTS ACTIVITIES OUTPUTS Intermediate Ultimate

Logic Model for the Wraparound, PBIS, and ESMH Pilot Project

June 21, 2006

TRAININGWraparound Coordinator(Intensive wraparound training, PBIS, crisis, community collaboration, family involvement)Wraparound Team (Intensive wraparound process, referral, family involvement, community collaboration, evidence-based practice)Community Partners (Wraparound overview, PBIS, school-based services, crisis intervention)Parents/Families (Wraparound overview, PBIS, mental health & stigma)Administrators (Integration of PBIS and wraparound, crisis management and planning, family involvement) Teachers/School Staff (Mental health identification, referral, crisis planning, family involvement, behavior management, wraparound)

TECHNICAL ASSISTANCE -Wraparound model-Universal PBIS-Evidence-based practice-Crisis planning & management-Community collaboration-Family Involvement-Mental Health Identification & Referral

LINK EXISTING AGENCIES, SERVICES & INTIAITVES

-School-based mental health-Community-based programs and services-School re-entry-Crisis management-Core service agencies-Children’s Cabinet Systems of Care-MH Transformation Grant

IMPLEMENT SCHOOL-BASED WRAPAROUND

-Assessment-Family involvement-Care Coordination-Integration of services-Mental health services-Program placement-Crisis planning & management

Reduction in inappropriate

referrals for services

Reduction in office discipline referrals

Reduction in suspensions and

acts of school violence

Increased time on task & opportunity

for learning

Reduction of risk factors and increase in protective factors

in children and adolescents

Reduction in need for juvenile services and child protective

services

Increased graduation rates and reduced high school dropout

Reduced disproportionality in

achievement & discipline problems

Increased parental involvement in

educational process

Increased teacher-efficacy for behavior

management

Increased academic performance

Staff available to participate in

wraparound process

80% School-wide universal PBIS implementation

Need and buy-in from school and community

District-level infrastructure to support PBIS,

wraparound, and system integration

Multiple district, state, agency, family, and

university partnerships

Regional expertise in PBIS, evidence-based

practice, family involvement, and

crisis management

Increased linkage protocols,

communication, & coordination across

agencies

Knowledge Transfer-Skills in detecting signs and symptoms of MH problems-Understanding risk and protective factors-Managing mental health problems in schools-Understanding the value of and strategies to encourage family and community partnerships-Implementation of wraparound process-Knowledge of available resources

Improved crisis planning and management

Further stabilization of universal PBIS systems

Development of secondary and tertiary

PBIS systems

Increased use of evidence-based

practices

Maryland Resources

www.pbismaryland.org

www.msmha.org